Patient arm support and method for supporting a patient&#39;s arm

ABSTRACT

A patient arm support, a method for using thereof, for supporting an arm of a patient during an operation when said patient is lying in a supine position on an operating table. The patient arm support has a base, an upper surface opposite to the base shaped to receive and to secure onto the patient arm support at least a portion of the arm; a proximal end; a distal end; a groove, running along at least a portion of a length of the upper surface of the patient arm support, for receiving at least one of at least a portion of the arm and a hand joined to the arm.

The present application claims priority of U.S. provisional patentapplication No. 62/427,888 filed on Nov. 30, 2016.

TECHNICAL FIELD

The present disclosure relates to surgical patient arm supports andmethods for supporting a patient's arm during a surgical operation.

BACKGROUND

Perioperative peripheral nerve damage during surgical operations resultsin a significant source of morbidity and paresthesias for patients andis a common cause of professional liability for anesthesiologists. Nervedamage may be caused by the patient remaining immobile for a significantperiod during the operation while they are anesthetized.

The nerve that is the most common site of post-operative nerve damage isthe ulnar nerve, accounting for over 25% of claims foranesthesia-related nerve injuries in the ASA closed claims database.This nerve runs between the humerus bone and the olecranon process ofthe ulna bone and is the largest unprotected nerve in the human body. Asource of damage to the ulnar nerve during an operation is continuouspressure on the nerve, such as from the weight of the upper arm, whilethe patient maintains the same position during the procedure. Aspressure is continuously applied onto the nerve, this results in thereduction of vascular perfusion, which may lead to irreparable nervedamage. The ulnar nerve is particularly vulnerable to compressioninjury, especially when the forearm is extended and pronated.

Furthermore, it has been found that damage to the ulnar nerve may,nevertheless, occur despite the presence of padding (such as paddingprovided by a soft surface covering the operating table), this paddingproviding cushioning namely at the elbow. Supination of the patient'sarms has, also, not been an adequate solution to prevent nerve injury asthere still have been reports of damage to the ulnar nerve despitesupination.

Aside from the ulnar nerve, damage to other nerves in the arm, such asthe brachial plexus, the radial nerve or the median nerve may alsoresult due to similar strain and compression during surgery. Forinstance, most brachial plexus related nerve injuries are caused bystretching and traction of the plexus. This may result when armabduction is equal to or greater than 90 degrees. As for the radialnerve, it may be subject to compression injury, as a result of pressureapplied by, for example, the underlying bone, or an improperly appliedor used medical instrument. As for damage to the median nerve, it mayresult when the wrist is extended beyond a comfortable range.

In order to remedy possible nerve damage, one solution is to add a soft,flat and slightly elevated brace in which the arm may rest, with theelbow facing down into the soft material of the brace. However, asmentioned herein, studies have shown that damage to the nerves, such asthe ulnar nerve, may still result, despite the padding provided by thiskind of brace.

Reference will now be made to FIG. 1. FIG. 1 depicts an example of theprior art, wherein the patient's arms rest directly upon an operatingtable 20, the operating table 20 having a padding material 26 on top ofa solid hard surface 25. In this FIG. 1, the patient would be placed inthe supine position, with the patient's arms extended perpendicularlyaway from the body. The operating table 20 has a core portion 24. Joinedto the core portion 24 is a lateral portion 22. This lateral portion 22supports the arms in a designated position, such as when the arms lieperpendicular to the body. The lateral portion 22 may also be describedas an armboard. In exemplary operating tables 20, each of the lateralportions 22 (one for each arm) may swivel along the same plane as thecore portion 24 from a point at which these lateral portions 22 arejoined to the core portion 24, thus allowing the arms to be placed, forinstance, nearer the patient's head, at a position perpendicular to thebody, or further from the patient's head and closer to the patient'swaist, depending on the positioning of the lateral portion 22 withrespect to the core portion 24. The surface of the lateral portion 22 isflush with the core portion 24. The patient's shoulder complex restsdirectly on the padding 26 of the operating table 20. Each of the armsis extended and rests on each of the lateral portions 22, as each of theupper arm 12 extends, naturally downwards from the shoulder to thesurface of the operating table 20. This downward position stretches thebrachial plexus and puts undesired strain on the nerves of the arm. Thisstretching may, thus, cause damage to the nerves of the arm, resultingin paresthesia and/or paralysis. Furthermore, as the upper arm 12 issloped downward towards the elbow, this angle can, also, result inundesired pressure being applied onto the elbow. The elbow rests on thesurface of the operating table 20 such that the weight of the whole armis supported by the elbow resting on the operating table 20. Thisresults in undesired pressure to the unprotected ulnar nerve. Despitethe presence of the padding 26, uninterrupted pressure on the ulnarnerve, such as during a surgical operation, could lead to damage to thisnerve. This is a result of reduction of blood flow to the nerve.

As the hand 14 is also lying flat on the padding 26, this position ofthe hand 14 may also result in over-extension of the wrist, due to theangle formed between the hand 14 and the forearm 13. This may undulystress the median nerve and may result in paresthesia, carpal tunnel andpossible nerve damage. There is also a risk of developing edema of thehand.

Furthermore, when preparing the patient for an operation, theanesthesiologist may use blankets to provide warmth, protection andsupport for the arms. As such, the arms may be wrapped in theseblankets. Blankets may also be folded or rolled and placed under the armin order to lift the arm so it may rest above the operating table 20 onthe blankets. However, such padding and protection from the blankets maynot be sufficient to avoid nerve damage during an operation.

Moreover, an additional flat support of a defined thickness may beplaced under a portion of the arm, laid on the lateral portion 22 of theoperating table 20, in order to lift the arm up from the operating table20 and to provide extra padding. This flat support may be a gel pad. Theflat support on its own is not sufficient to eliminate injury to thenerves as it does not correct such underlying problems as, for example,the angle between the upper arm 12 and the forearm 13, as the upper arm12 is angled downwards from the shoulder.

SUMMARY

When the patient's arm is resting on a patient arm support and when thepatient is lying in the supine position, it has been discovered thatproviding the patient arm support with a gap at the location where theelbow of the patient is positioned may reduce injury to the ulnar nerveduring an operation. The gap provides sufficient space for the elbow sothat the elbow does not come into contact with the surface of thepatient arm support. This absence of contact reduces the possibilitythat pressure will build up on the portion of the cavity at the elbowwhere the ulnar nerve is exposed.

Furthermore, it has been discovered that extending the patient armsupport so it can support the full length of the patient's arm and atleast a portion of the patient's shoulder complex, in some cases wellunder the scapula, may reduce traction and hypoperfusion of the brachialplexus. Furthermore, for patients prone to dislocation at the level ofthe shoulder, the shoulder complex portion of the patient arm supportmay also reduce the risk of shoulder dislocation or strain during thecourse of the operation.

A broad aspect of the disclosure is a method for supporting a patient'sarm and for preventing paraesthesia in the arm by using a patient armsupport during an operation when the patient is in a supine position onan operating table. The method includes laying the patient in a supineposition on the operating table. The method includes placing the arm ofthe patient on the patient arm support so that a tapered wedge portionof the patient arm support is wedged between at least a part of ashoulder complex of the patient and the operating table and where thetapered wedge portion elevates the at least a part of the shouldercomplex for limiting the stretching of nerves and blood vessels of thebrachial plexus. The method includes repositioning the patient armsupport so that an elbow of the arm is positioned in an elbow region ofthe patient arm support for receiving the elbow and for avoiding harmfulpressure on an ulnar nerve.

In some embodiments, the method may include supporting with a handportion of the patient arm support an entire back of a hand joined tothe arm.

In some embodiments, the method may include placing fingers of the handin an upward curved position while the hand is resting on an upwardcurved portion of the hand portion.

In some embodiments, the method may include anesthetizing the patient.

In some embodiments, the method may include positioning a wrist of thepatient in a wrist region of the patient art support for receiving thewrist.

In some embodiments, the method may include massaging the arm by pumpingair through air pockets of the patient arm support using an air pump.

Another broad aspect of the disclosure is a patient arm support forsupporting an arm of a patient during an operation when the patient islying in a supine position on an operating table. The support includes abase, for resting the patient arm support on a surface. The supportincludes an upper surface opposite to the base shaped to receive and tosecure onto the patient arm support at least a portion of the arm. Thesupport includes a proximal end, and a distal end opposite to theproximal end. The support includes a thickness, perpendicular to thebase, measured from the base to the upper surface. The support includesa groove, running along at least a portion of a length of the uppersurface of the patient arm support, for receiving at least one of atleast a portion of the arm and a hand joined to the arm. The supportincludes a tapered wedge portion at the proximal end, the tapered wedgeportion having a shoulder complex receiving surface for receiving atleast a part of a shoulder complex of the patient, the tapered wedgeportion gradually increasing in the thickness as a function of adistance from the proximal end for elevating the at least a part of theshoulder complex above the operating table, for limiting the stretchingof nerves and blood vessels of the brachial plexus. The support includesan elbow region for receiving an elbow of the arm to avoid any harmfulpressure on an ulnar nerve. The support includes an upper arm portionfor receiving an upper arm of the arm, wherein the thickness of theupper arm portion is greater nearer the proximal end than nearer theelbow region. The support includes a forearm portion for receiving aforearm of the arm, wherein the thickness of the forearm portion islesser nearer the elbow region than nearer the distal end.

In some embodiments, the support may include a hand portion near thedistal end for receiving the hand.

In some embodiments, the hand portion may include an upward curvedportion for resting fingers of the hand in an upward curved positionwhile the fingers rest on the upward curved portion of the hand portion.

In some embodiments, the thickness of the upper arm portion nearer theproximal end may be similar to the thickness of the hand portion.

In some embodiments, the support may include a wrist region forreceiving a patient's wrist.

In some embodiments, the support may include a wrist marking on anoutside surface of the patient arm support for indicating a location ofthe wrist region.

In some embodiments, the wrist region may include a cavity.

In some embodiments, the patient arm support may include a fasteneradapted to fasten the patient arm support to the operating table.

In some embodiments, the fastener may include a hook and loop fasteningmeans.

In some embodiments, the fastener may include at least one strap forattaching the patient arm support to the operating table.

In some embodiments, the support may include an air pump and air pocketsfor massaging the patient's arm, wherein air is directed to the airpockets by the air pump.

In some embodiments, the support may include an elbow marking on anoutside surface of the patient arm support for indicating a location ofthe elbow region.

In some embodiments, the elbow region may include a cavity.

In some embodiments, the patient arm support may include two walls,wherein a first wall of the two walls may be of a first length and mayrun at least part of a length of the groove on a first side of thegroove, and a second wall of the two walls may be of a second length andmay run at least a part of the length of the groove on a second side ofthe groove, wherein the first length of the first wall may be less thanthe second length of the second wall.

Another broad aspect of the disclosure is a method for supporting apatient's arm during an operation when the patient is lying in a supineposition on an operating table and for preventing paraesthesia in thearm by using a patient arm support having a proximal tapered wedgeportion comprising supporting at least a part of a shoulder complex ofthe patient to elevate the at least a part of the shoulder complex withrespect to the operating table for limiting the stretching of nerves andblood vessels of the brachial plexus to avoid paraesthesia in the arm.

BRIEF DESCRIPTION OF DRAWINGS

The invention will be better understood by way of the following detaileddescription of embodiments of the invention with reference to theappended drawings, in which:

FIG. 1 is a cross-sectional view of a portion of the upper half of apatient lying in a supine position on an operating table according tothe prior art when the patient is lying in a supine position.

FIG. 2 is a cross-sectional view of an exemplary patient arm support,when a patient is lying in a supine position on an operating table andthe patient's arm is resting on the patient arm support.

FIG. 3 is a lateral view of an exemplary patient arm support.

FIG. 4 is a front top-down of the overlaying layer and the mold layer ofan exemplary patient arm support.

FIG. 5A is a lateral view of a patient lying in a supine position on anoperating table with each of the patient's arms resting respectively inexemplary patient arm supports.

FIG. 5B is a bottom-up view of a patient lying in a supine position witheach of patient's arms resting respectively in exemplary patient armsupports.

FIG. 6 is a flowchart diagram of an exemplary set of steps forpositioning a patient on an operating table with an exemplary patientarm support.

FIG. 7A is a lateral top-down view of an exemplary patient arm support.

FIG. 7B is a front-lateral top-down view of an exemplary patient armsupport.

FIG. 7C is a front view of an exemplary patient arm support.

FIG. 7D is a lateral view of an exemplary patient arm support.

FIG. 8A is a lateral top-down view of the overlaying layer and the moldlayer of an exemplary patient arm support.

FIG. 8B is a side view of the overlaying layer and the mold layer of anexemplary patient arm support.

FIG. 8C is a bottom-up view of the overlaying layer and the mold layerof an exemplary patient arm support.

FIG. 8D is a lateral side view of the overlaying layer and the moldlayer of an exemplary patient arm support.

FIG. 9A is a drawing of a first side view of an exemplary patient armsupport.

FIG. 9B is a drawing of a second side view of an exemplary patient armsupport.

FIG. 9C is a drawing of a front view of an exemplary patient armsupport.

FIG. 9D is a drawing of a back view of an exemplary patient arm support.

FIG. 9E is a drawing of a top view of an exemplary patient arm support.

FIG. 9F is a drawing of a bottom view of an exemplary patient armsupport.

DETAILED DESCRIPTION

In the present detailed description, the word “arm” is defined as theentire arm, from the shoulder joint to the wrist, this including theupper arm and the forearm.

The expression “shoulder complex” is defined as the acromioclavicular,sternoclavicular, glenohumeral and scapulothoracic joints, and theirassociated muscles and bones attached to the scapula.

The patient arm support described herein and methods for using samerelate to providing support to at least one arm during a surgicaloperation while minimizing undue pressure on the nerves and loss ofblood flow in the arm.

FIGS. 2 and 3 illustrate an exemplary patient arm support 30. Thepatient arm support 30 is shaped to receive the arm of a patient lyingin a supine position during, for instance, an operation. In the supineposition, the patient's arm may be resting on a patient arm support 30on top of a lateral portion 22 of an operating table 20 (i.e. armboards)forming an angle of 90 degrees or less with the core portion of theoperating table 20. The lateral portion 22 may be parallel with thefloor. The lateral portion 22 may be level with the core portion 24 ofthe operating table 20. The core portion 24 of the operating table 20may be defined as the portion of the operating table 20 receiving atleast the trunk of the patient.

Even though the patient arm support 30 may be used during a surgicalprocedure, the patient arm support 30 can also be used for any procedureor time when a person is to lie on his or her back for a prolongedperiod with limited to no movement. Such instances may be, for instance,during convalescence or when a patient is confined to bed for aprolonged time.

In the case of a surgical operation during which the patient isanesthetized, the patient remains immobile which may result in growingpressure points at different locations on the patient's body. Suchpressure points can lead to nerve damage. Therefore, the patient armsupport 30 may be used to position the arm in a relaxed position whilereducing pressure exerted on portions of the arm which may namely leadto nerve damage.

During an operation, one patient arm support 30 may be used, oralternatively, two patient arm supports 30 may be used, where each ofthe patient arm supports 30 is used to support one of the patient'sarms.

The patient arm support 30 has a base 46 for resting on a surface suchas an operating table 20. On the opposite side of the base, the patientarm support 30 has a resting surface 47 on which the patient's arm isplaced and may rest. The patient arm support 30 also has a proximal end48 and a distal end 49 opposite to the proximal end 48.

The patient arm support 30 has a tapered portion 32 at the proximal end48, a set of walls 36 and a groove 37. The patient arm support 30 alsohas an upper arm portion 31A, a forearm portion 34 and an elbow gap 31shaped to receive an elbow, the elbow gap 31 located between the upperarm portion 31A and the forearm portion 34. The patient arm support 30may also have a wrist region 42 and a hand portion 33 near the distalend 49. The hand portion 33 may also have an upward curved portion 43.

As shown in FIG. 3, the patient arm support 30 has a groove 37 forreceiving at least a portion of the patient's arm. The groove is a spaceon the top surface of the patient arm support 30, on which the patient'sarm is to be placed. The groove 37 may extend across the upper armportion 31A, the forearm portion 34 and optionally, the hand portion 33.The groove 37 is shaped to receive the patient's arm.

The patient arm support 30 has a tapered portion 32 which rests under atleast a part of the patient's shoulder complex 11. This tapered portion32 is wedged between the shoulder complex 11 and the operating table 20.The tapered portion 32 may be wedge shaped, where the thinnest portionis placed between the patient's shoulder complex 11 and the surface onwhich the patient is resting (e.g. the operating table 20). The weightof at least a part of the shoulder complex 11 on the tapered portion 32may provide anchoring of the patient arm support 30 to the operatingtable 20, as the weight of the body of the patient may hold the taperedportion 32 and the patient arm support 30 in place. The slope of thetapered portion 32 may be of a gentle upward incline in order toslightly elevate the patient's arm and reduce strain on the brachialplexus and the shoulder joint, including the muscles, tendons and nerveslocated in proximity to the shoulder joint, this incline illustrated forexample by curve 51B (following the slope of the shoulder and shouldercomplex 11) when compared with the flatter incline representing that ofthe shoulder and shoulder complex, as shown by curve 51A in the priorart FIG. 1A. This reduction in strain may also provide support topatients who are predisposed to shoulder dislocation, by reducing thestrain applied to the shoulder when lying in a supine position.Furthermore, the upper surface of the tapered portion 32 on which reststhe shoulder complex 11 may be slightly curved to cup and mold to theshoulder complex 11 and upper portion of the patient's back. In someembodiments, the tapered portion 32 may be shaped to fully extend acrossthe full length of the shoulder complex 11. In other embodiments, thetapered portion 32 may be shaped to extend across only a portion oflength of the patient's shoulder complex 11.

The tapered portion 32 may also slightly lift the shoulder complex 11above the operating table 20, where the tapered portion 32 risesslightly the shoulder complex 11 from the operating table 20. Thisrising of the shoulder complex 11 and the support provided by thepatient arm support 30 to the upper arm 12 in turn may also result inreducing the downward angle of the upper arm 12. In FIG. 1A, the upperarm 12 naturally slopes downward as a result of the upper arm 12 and theshoulder complex 11 lying directly on the flat operating table 20. Thispositioning adds strain on the brachial plexus and the portion aroundthe shoulder joint, such as the rotator cuff. Furthermore, the inclinedposition of the upper arm 12 may also add additional weight on theelbow, such as the weight of the arm on the elbow, which may result inapplying undesired pressure on the ulnar nerve, increasing the risk ofdamage to this nerve as a result of compression. As shown in FIG. 2, byelevating the shoulder complex 11 slightly above the operating table 20and by maintaining or only slightly reducing this elevation for the restof the arm supported by the patient arm support 30, the upper arm 12 mayalso gently slope downward. However, the weight of the arm is supportedand may be distributed along the upper arm portion 31A. This positionmay also reduce strain in the area around the shoulder joint. Second, asthe upper arm's 12 downward slope is minimized, this position of theupper arm 12 may diminish the pressure caused by the arm to the elbowand the ulnar nerve, the weight of the upper arm 12 distributed alongthe padding of the upper arm portion 31A instead of focused towards theelbow region. This may limit the risk of injury to the ulnar nerve as aresult of compression.

Alternatively, and aside or in addition to the tapered portion 32anchoring the patient arm support 30 in place, the patient arm support30 may be held in place using a fastening means, such as a hook and loopfastener 57 like Velcro®, wherein a strip of the fastening means liesacross the operating table 20, spanning from one lateral portion 22 tothe other or at least across certain portions of each of the lateralportions 22, and where the complementary strip is found at the base ofthe arm patient support 30 for adhering to the strip found on theoperating table. The fastening means would allow each patient armsupport 30 to be placed at a designated location on the operating table20, for limiting movement during the operation procedure, where thefastening means found on the patient arm support 30 may be joined at thedesired location to the complementary portion of the fastening meansrunning across the operating table where the patient's arms are to lie.For instance, the hook portion of the hook and loop fastening means maybe joined to the base of the patient arm support 30 and thecorresponding loop portion of the hook and loop fastening means may bejoined to the lateral portion 22 of the operating table 20. Once thepatient arm support 30 is properly positioned at a desired location toreceive the patient's arm, then the hook portion and loop portion may bejoined, holding the patient arm support 30 in place during theoperation. In the case where two patient arm supports 30 are used (onefor each arm), this would allow, for instance, for adjustment of thedistance between each of the patient arm supports 30 in accordance withthe proportions of the patient, such as the distance between each of thepatient's shoulder complex 11. A skilled person will readily recognizethat other forms of fastening may be used, such as an elastic strap oran adjustable strap 56 attached to the patient arm support 30 that maywrap around the lateral portion 22 of the operating table 20 and holdthe patient arm support 30 in place, without departing from the presentteachings. In other embodiments, the fastening means may be a series ofsnaps, where, for instance, a male part of the snap fastener is locatedon the base of the pillow and the female part of the snap fastener islocated on, for example, the lateral portion 22 of the operating table20. In another embodiment, the fastening means may be a sleeve, to whichthe patient arm support 30 is attached, where the sleeve is shaped tohug the contours of at least a portion of the lateral portion 22 of theoperating table 20, the lateral portion 22 of the operating table 20inserted into the sleeve. The sleeve may be of a stretchable or elasticmaterial to provide a snug fit around the lateral portion 22.

The patient arm support 30 may also have an upper arm portion 31A. Theupper arm portion 31A receives the upper arm 12 of the patient. In someembodiments, the upper arm portion 31A may be parallel with theoperating table 20. In other embodiments, the upper arm portion 31A mayhave a slight incline downward. In the embodiment of the patient armsupport 30 where the upper arm portion 31A has a slight downwardincline, when the patient's arm is resting in this exemplary embodimentof the patient arm support 30, the portion of the upper arm 12 nearer tothe shoulder is slightly more elevated from the base 46 than the portionof the upper arm 12 located nearer to the elbow.

In some embodiments, when a patient's arm and hand 14 is resting on anexemplary patient arm support 30, the patient's shoulder and the portionof the patient's upper arm 12 nearest to the shoulder may beapproximately at the same height from the base 46 as the patient's hand14. The hand portion 33, the portion of the forearm portion 34 nearer tothe hand portion 33, and the portion of the upper arm portion 31A nearerthe proximal end 48, may be near the same height so as to maintain bloodflow in the hand 14 and the fingers of the hand 14 while the patient'sarm and hand 14 are resting on a patient arm support 30.

The patient arm support 30 has an elbow region 31 in the groove 37 forreceiving the elbow of the patient's arm. The elbow region 31 may be acavity and is shaped with a sufficient depth and width so as toaccommodate the patient's elbow and minimize contact of the surface ofthe patient arm support 30 on the elbow which may lead to undesirablepressure during, for example, the course of a surgical operation. Insome embodiments, the elbow region 31 is of such dimensions so thatthere is no contact between the elbow and the patient arm support 30when the patient's arm is resting on the patient arm support 30. In someembodiments, the elbow region 31 may be of a half-moon shape, forming ahalf-moon indentation in the groove 37 of patient arm support 30. Inother embodiments, the elbow region 31 may be, for example, of arectangular prism shape. It may be appreciated that the elbow region 31may be of any shape that creates sufficient spacing between thepatient's elbow and the surface of the patient arm support 30, so as tolimit and/or eliminate contact between the patient arm support 30 andthe elbow. In some embodiments, the elbow region 31 may be filled with avery soft foam, where little to no pressure is applied by the foam tothe elbow.

Furthermore, the elbow region 31 may separate the upper arm portion 31Afrom the forearm portion 34.

The patient arm support 30 may have an elbow marking 44 located on theoutside surface 41 of the patient arm support 30. This elbow marking 44may be in the form of an arrow, or a straight line, indicating to, forexample, an orderly or nurse the location at which the patient's elbowis to be placed in the patient arm support 30. The elbow marking 44 isaligned with the elbow region 31. The elbow marking 44 may facilitatethe positioning of the arm when preparing for a surgical operation, byassisting the surgical staff with the positioning of the patient armsupport 30 so that the elbow is aligned with the elbow region 31, forprotecting the ulnar nerve. Furthermore, for instance, in an embodimentof the patient arm support 30 where the walls 36 of the patient armsupport 30 are opaque, and where the elbow region 31 may not be easilyvisible when adjusting the patient's arm in the patient arm support 30,the elbow marking 44 may allow for facilitating the alignment of theelbow with the elbow region 31 made to receive the elbow of the patient.

The patient arm support 30 has a forearm portion 34. The forearm portion34 is shaped to receive the forearm 13 of the patient. The forearmportion 34 may have a slight upward incline, as such that when thepatient's arm is resting in the patient arm support 30, the portion ofthe patient's forearm 13 located nearer to the elbow is lower withrespect to the base 46 than the portion of the patient's forearm 13located nearer to the wrist. A person skilled in the art will readilyrecognize that the angle of this incline may vary without departing fromthe present teachings.

The patient arm support 30 also has a hand portion 33 for receiving theentire hand 14 of the patient. This hand portion 33 may also beinclined, where, in some embodiments, the incline of the hand portion 33may be the same as that of the forearm portion 34. In other embodiments,the incline of the hand portion 33 may be greater or lesser than that ofthe forearm portion 34. The slight upward inclined of the hand portion33 may reduce a strain applied to patient's wrist and to the mediannerve which would have otherwise resulted from the over extension of thewrist. When the patient is resting on the patient arm support 30, thepatient's arm and hand may be placed in the supination position or theneutral position.

Optionally, the hand portion 33 may be shaped in such a way as to allowthe fingers of a patient, when the fingers are resting on the handportion 33, to remain curved slightly upwards while resting on an upwardcurved portion 43 of the hand portion 33. The upward curved portion 43may be placed at the furthest region of the hand portion 33 with respectto the tapered portion 32 and has a slight upward curve.

Optionally, there may be a wrist region 42 for receiving the wrist ofthe patient, extending from the patient's arm. The wrist region 42 maybe of a soft foam material for minimizing pressure to the wrist or maybe an empty cavity. The wrist region 42 may be located between theforearm portion 34 and the upper hand portion 33. The wrist region 42 isshaped with a sufficient depth and width so as to accommodate thepatient's wrist and minimize over extension of the wrist, which mayprevent, for instance, compression of the median nerve. In someembodiments, the wrist region 42 may be of a half-moon shape, creating ahalf-moon indentation in the patient arm support 30. In otherembodiments, the wrist region 42 may be a shallow concavity in thesurface of the groove 37. However, it will be appreciated that the wristregion 42 may be of any shape that creates sufficient spacing betweenthe patient's wrist and the surface of the patient arm support 30, so asto limit and/or eliminate contact between the patient arm support 30 andthe wrist.

The patient arm support 30 may have a wrist marking 45 located on theoutside surface 41 of the patient arm support 30. The wrist marking 45may be in the form of an arrow, or a straight line, for indicating to,for example, an orderly or nurse the location at which the patient'swrist is to be placed in the patient arm support 30. The wrist marking45 is aligned with the wrist region 42. The wrist marking 45 mayfacilitate the positioning of the patient arm support 30 when preparingfor a surgical operation for aligning the wrist region 42 with thewrist. Furthermore, in some embodiments of the patient arm support 30where the walls 36 of the patient arm support 30 are opaque, and wherethe wrist region 42 may not be easily visible when adjusting thepatient's arm in the patient arm support 30, the wrist marking 45 allowsfor facilitating the alignment of the wrist region 42 made to receivethe wrist of the patient with the wrist.

As shown in FIG. 3, the patient arm support 30 may have two walls 36,one on each side of the patient arm support 30. Each of the walls 36 isalso located on either side of the groove 37. The walls 36 secure thepatient's arm when resting in the patient arm support 30. The walls 36may also prevent the patient's arm from falling off of the operatingtable 20 when the patient's surgical position is changed during thecourse of an operation by securing the arm within the patient armsupport 30. The inside portion of each of the walls 36 forms a curvedsurface with the groove 37 for receiving the patient's arm. The groove37 may also prevent the patient's arm from falling from the patient armsupport 30.

In some embodiments, the patient arm support does not have a groove 37or walls 36. Instead, the patient's arm may be secured to the patientarm support using a strap passing around the patient's arm. This strapmay also prevent the patient's arm from falling during the course of theoperation.

In some embodiments, as shown in FIG. 9A to 9F, the patient arm support30 may have at least one wall 36B that spans only part of the length ofthe patient arm support 30. The partial wall 36B may allow for thepatient's arm to be easily placed in the patient arm support 30. Wall36A and wall 36B assist with securing the arm in the groove of thepatient arm support 30. Partial wall 30B may be found on the side of thepatient arm support 30 that will be facing the feet of the patient whenthe patient is placed in a supine position on an operating table, andthe patient's arm is positioned in the patient arm support 30. The wall36A may span a greater length of the patient arm support 30. In someembodiments, wall 36A may span the full length of the patient armsupport 30. It will be understood that in the embodiments of the patientarm support 30 that include a wall 36A and a wall 36B, the patient armsupport 30 may be adapted for a right arm or for a left arm such thatthe wall 36B is positioned on the patient arm support 30 such that wall36B is facing the feet of the patient when the patient's arm is placedin the patient arm support 30 and the patient is in a supine position onan operating table.

In one embodiment, the patient arm support 30 may be dimensioned in sucha way so as to accommodate the arm of a large male patient. Thedimensions in one example may b as follows: the length of the patientarm support 30 may be 32 inches for accommodating the arm of a largemale, and the width of the patient arm support 30, measured from theoutside portions of the walls 36, may be 6.75 inches. The height of thepatient arm support 30 at the distal end 49, measured perpendicularlyfrom the base 46, may be of 3.9 inches. The dimensions of the patientarm support 30 may be configurable in order to adjust to the arm lengthand proportions of the patient. In some examples, the different patientarm supports 30 may be available in different standard sizes foraccommodating different sized patients (e.g. a size for children, a sizefor average size adults and a size for tall adults). In an alternativeembodiment, each of these standard models of the patient arm support 30may be provided with an adjustable feature, where the patient armsupport 30 may be slightly stretched or adjusted in order to match theproportions of the patient's arm.

In an alternative embodiment, as shown in FIG. 4, an exemplary patientarm support 30 may comprise air pockets 38 for massaging the patient'sarm as an air pump circulates air through these pockets. This massagingmay also remove, reduce or redirect pressure exerted on the arm and itsnerves resulting from contact between the arm and the patient armsupport 30, and may promote circulation in the arm. In an exemplaryembodiment, the patient arm support 30 may be composed of two layers. Afirst, underlying mold-layer 39A may be shaped to define the differentair pockets ranging across the patient arm support 30 for massaging. Asecond, overlaying layer 39B, placed on top of the mold layer 39A,making contact with the mold layer 39A and which may result in a partialseal between the two layers 39A and 39B, where the pockets 38 in whichair may be pumped and circulated are sealed, creating passageways forthe air. As pressure increases in the pockets 38 as a result of the airpump, the air exerts a force upon the overlaying layer 39B, this forcecausing the layer 39B to stretch and release, this change in the layer39B massaging the patient's arm. In another embodiment, the patient armsupport 30 may be composed of a single material, the pockets 38 presentwithin the patient arm support 30. Furthermore, in alternativeembodiments, massaging may be provided instead by a motor mechanism, themotor creating for instance slight undulations or vibrations in thematerial on which the patient's arm is resting.

The outer surface of the patient arm support 30 may be composed of asoft, flexible material for cushioning the patient's arm. In someembodiments, the patient arm support 30 may be made of inert, latex-freeand/or fireproof materials. The patient arm support 30 may be composedof hypoallergenic material in order to reduce the probability of anallergic reaction resulting from, for instance, the patient's skinreacting to the material. In some embodiments, the patient arm supportmay be made out of a soft two-component platinum silicone casting foam,such as the foam Soma Foama® of Smooth-On Inc.

FIG. 5A shows a model of a patient lying on the operating table 20,where both of the patient's arms are resting in their own respectiveexemplary patient arm supports 30. For each of the patient arm supports30, the entire length of the arms as well as the entire hand is receivedby the patient arm support 30. The tapered portion 32 is positionedunder the patient's shoulder complex and may be anchored in place by theweight of the patient applied onto the tapered portion 32 of the patientarm support 30.

As shown in FIG. 5B, the tapered portion 32 may extend fully across thepatient's shoulder complex, providing anchorage of the patient armsupport 30 to the operating table by the patient's upper body, andprovide a gentle steady incline away from the proximal end 48, where thepatient's shoulder complex and elbow are slightly lifted, resulting inless pressure on the brachial plexus and the shoulder joint.

FIG. 6 shows an exemplary method 50 for positioning a patient's arm on apatient arm support 30 during a surgical operation. First, the patientarm support 30 is positioned on the operating table at step 51. When twoof the patient arm supports 30 are used, the distance between bothpatient arm supports 30 should be such that the tapered portion 32 ofeach of the patient arm supports 30 may accommodate the shoulder complex11 of a patient lying in the supine position. In some embodiments, whentwo patient arm supports 30 are placed one facing the other in order toreceive each of the patient's arms, each of the tapered portions 32 ofthe patient arm supports 30 may be shaped so that one tapered portion 32may be tucked under the other tapered portion 32 in order to adjust thepatient arm support 30 to the length of the patient's arm(s). Thepatient arm support 30 is positioned on the operating table so as toreceive the arm of the patient resting in a supine position. The patientarm support 30 may thus be placed on the lateral portion 22 of theoperating table.

Optionally, the patient arm support 30 may be secured in place onto theoperating table 20 using a fastening means as described herein.

The patient is laid down onto the operating table 20 in the supineposition and the shoulder complex 11 of the patient is positioned overthe tapered portion 32 of the patient arm support 30 at step 52. Theweight of the patient, exerted on the tapered portion 32 of the patientarm support 30 and wedging the tapered portion 32 against the operatingtable 20, may secure the patient arm support 30 in place.

The patient's arm, or at least a portion of the patient's arm, is thenplaced in the groove 37 of the patient arm support 30 at step 53.Optionally, size adjustments of the patient arm support 30 may be madein order to accommodate different arm lengths and proportions.

The arm is positioned in such a manner so as to not over-extend or causeundue extension or flexion at the level of the joints, in a supineposition. When placing the arm in the patient arm support 30, thepatient arm support 30 is adjusted so that the elbow is positioned inthe elbow region 31 of the groove 37 at step 54A. This positioning mayreduce pressure exerted by the surface of the patient arm support 30 onthe elbow and the ulnar nerve during the operation. Optionally, when thepatient arm support 30 has an elbow marking 44 on its exterior markingthe location of the elbow region 31 in the groove 37, the elbow marking44 is aligned with the patient's elbow so that the elbow is positionedin the elbow region 31 at step 54B.

The patient's hand 14 may then be placed on the hand portion 33 of thepatient arm support 30, where the palms may be facing up, at step 55A.The hand support 33 may accommodate the entire hand 14 of the patient.An upward curved portion 43 of the hand support 33 may be shaped inorder to allow the fingers of the patient's hand 14 to rest in aposition where the fingers are curled slightly upward.

Optionally, when the patient arm support 30 has a wrist region 42 and awrist marking 45 indicating the position of the wrist region 42 in thegroove 37, the patient's wrist may be aligned with the wrist marking atstep 55B. As such, the patient's wrist is positioned in the wrist region42.

Optionally, the arm resting in the patient arm support 30 may bemassaged using a massaging mechanism, such as an air pump flowingthrough cavities positioned under the surface on which the arm isresting.

The description of the present invention has been presented for purposesof illustration but is not intended to be exhaustive or limited to thedisclosed embodiments. Many modifications and variations will beapparent to those of ordinary skill in the art.

1. A method for supporting a patient's arm and for preventingparaesthesia in said arm by using a patient arm support during asurgical operation when said patient is in a supine position on anoperating table comprising: laying said patient in a supine position onsaid operating table; placing said arm of said patient, extendedperpendicularly away from a body of the patient, on said patient armsupport so that a tapered wedge portion of said patient arm support isplaced under at least part of a shoulder complex and wedged between saidat least a part of said shoulder complex of said patient and saidoperating table and where said tapered wedge portion elevates said atleast a part of said shoulder complex for limiting the stretching ofnerves and blood vessels of the brachial plexus; and repositioning saidpatient arm support so that an elbow of said arm is positioned in anelbow region of said patient arm support for receiving said elbow andfor avoiding harmful pressure on an ulnar nerve.
 2. The method asdefined in claim 1, further comprising supporting with a hand portion ofsaid patient arm support an entire back of a hand joined to said arm. 3.The method as defined in claim 2, further comprising placing fingers ofsaid hand in an upward curved position while said hand is resting on anupward curved portion of said hand portion.
 4. The method as defined inclaim 1, further comprising anesthetizing said patient.
 5. The method asdefined in claim 1, further comprising positioning a wrist of saidpatient in a wrist region of said patient art support for receiving saidwrist.
 6. The method as defined in claim 1, further comprising massagingsaid arm by pumping air through air pockets of said patient arm supportusing an air pump. 7-20. (canceled)
 21. A method for supporting apatient's arm during a surgical operation when said patient is lying ina supine position on an operating table and for preventing paraesthesiain said arm by using a patient arm support having a proximal taperedwedge portion comprising supporting at least a part of a shouldercomplex of said patient with said tapered wedge portion to elevate saidat least a part of said shoulder complex with respect to said operatingtable for limiting the stretching of nerves and blood vessels of thebrachial plexus to avoid paraesthesia in said arm.